Contraception - Intrauterine Device (IUD)

Monday 8th March 2010

An IUD is a small, T-shaped contraceptive device made from plastic and copper that fits inside the womb (uterus). It used to be called a coil or a loop.

It is a long-lasting and reversible method of contraception but it is not a barrier method. This means that an IUD cannot stop you getting sexually transmitted infections (STIs).

There are different types and sizes of IUD to suit different women. IUDs need to be fitted by a trained doctor or nurse at your GP surgery, local family planning clinic or sexual health clinic.

They can stay in the womb for five to 10 years depending on the type. If you are 40 or over when you have an IUD fitted, it can be left in until you reach the menopause or until you no longer need contraception.

Most women can have an IUD fitted, including women who have never been pregnant or who are HIV positive. An IUD is usually fitted during your menstrual period. From the moment the IUD is fitted until the time it is taken out, you are protected against pregnancy.

How it works

An IUD stops sperm from reaching the egg. It does this by releasing copper into the body, which changes the make-up of the fluids in the womb and fallopian tubes. These changes prevent sperm from fertilising eggs. IUDs may also stop fertilised eggs from travelling along the fallopian tubes and implanting in the womb.

How effective is an IUD?

An IUD is 98–99% effective at preventing pregnancy. Newer models that contain more copper are the most effective (over 99% effective). This means that less than one in every 100 women who use the IUD will get pregnant in a year.

As a long-lasting method of contraception, the IUD is very effective. You do not need to remember to take or use contraception to prevent pregnancy. However, it does not protect you against STIs.

Emergency contraception

The IUD can also be used as a method of emergency contraception up to five days after unprotected sex or up to five days after the earliest time you could have released an egg (ovulation). If you have unprotected sex, make an appointment with your GP or clinic as soon as possible.

Most women can use an IUD, including women who have never been pregnant and those who are HIV positive. Your GP or nurse will ask about your medical history to check if an IUD is the most suitable form of contraception for you.

You should not use an IUD if you have:

• any untreated sexually transmitted infections (STIs) or pelvic infection,
• problems with your womb or cervix, or
• any unexplained bleeding from your vagina, for example between periods or after sex.

Women who have had an ectopic pregnancy or recent abortion, or who have an artificial heart valve, must consult their GP before having an IUD fitted.

You should not be fitted with an IUD if there is a chance you are already pregnant or if you or your partner are at risk of catching STIs.

The IUD is most appropriate for women with one long-term partner, who they are confident does not have any STIs. If you or your partner are unsure, go to your GP or sexual health clinic to be tested for STIs.

Using an IUD after giving birth

An IUD is usually fitted four to six weeks after the birth (vaginal or caesarean). You will need to use alternative contraception from three weeks (21 days) after the birth until the IUD is fitted. In some cases, an IUD can be fitted within 48 hours of giving birth.

An IUD is safe to use when you are breastfeeding and will not affect your milk supply.

Using an IUD after a miscarriage or abortion

An IUD can be fitted after an abortion or miscarriage by an experienced doctor or nurse, as long as you were pregnant for less than 24 weeks. If you were pregnant for more than 24 weeks, you may have to wait a few weeks before having an IUD fitted.

Advantages of an IUD

• Most women can use an IUD, including women who have never been pregnant.
• Once an IUD is fitted, it is immediately effective at preventing pregnancy and will be for up to 10 years or until it is removed.
• It does not interrupt sex.
• It can be used if you are breastfeeding.
• Your normal fertility returns as soon as the IUD is taken out.
• It is not affected by other medicines.

There is no evidence that IUDs affect body weight or that having an IUD fitted will increase the risk of cancer of the cervix, endometrium (lining of the womb) or ovaries. Some women experience changes in mood and libido, but these are very small.

Disadvantages of an IUD

• Your periods may become heavier, longer or more painful, though this may improve after a few months.
• You have to have an internal examination to check whether an IUD is suitable for you and another one when it is fitted.
• An IUD does not protect against sexually transmitted infections (STIs), so you may have to use condoms as well. If you get an STI while you have an IUD fitted, it could lead to a pelvic infection if it is not treated.

Sourced from NHS Direct.

Had an IUD fitted? Let us know about your experiences with this form of contraception in the comments section below and help more women to make decisions about the contraceptions they choose.

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Contraception - Patches

Monday 8th February 2010

The contraceptive patch (transdermal) is a form of hormonal contraception that is worn by a woman to stop her getting pregnant when she has sex.

However, unlike like barrier methods of contraception, such as condoms, the contraceptive patch does not protect you from getting sexually transmitted infections (STIs).

The contraceptive patch is very reliable and easy to use. You stick it on a clean, dry, hair-free area of your body, such as your buttocks, stomach, chest (apart from your breasts) or the outside of your upper arm. Make sure the area of skin you choose is clean, dry and not hairy, and that it is not going to be rubbed by tight clothing. You should not put the patch on areas of the skin that are broken or irritated. The patch needs to be changed for a new one each week.

The patch protects you from pregnancy by introducing hormones into your body which prevent your ovaries from releasing an egg.

Every day, the patch gives you a dose of the female sex hormones, oestrogen and progestogen, that move through your skin and into your bloodstream. These hormones are similar to the hormones that are made naturally by your body, and they control your periods and help to prepare your body for pregnancy.

The hormones in the contraceptive patch stop your ovaries from releasing an egg each month (ovulation) which could then be fertilised by sperm. The combined oral contraceptive pill works in this way too.

The contraceptive patch also has some other effects. It makes the mucus in your cervix (entrance to the womb) get thicker. This makes it difficult for sperm to move through the mucus and into your womb, where it could reach an egg. It also makes the lining of your womb thinner, so that it is harder for an egg to attach to the womb where it could be fertilised.

If you start using the patch on the first day of your period, it starts working straight away. This means you can have sex without getting pregnant. If you start using it on any other day, you need to use an additional form of contraception for the first seven days.

The contraceptive patch is not suitable for everyone. If you are thinking of using the patch, the healthcare professional that you see will first ask you about your health and your family medical history. It is very important to tell them about any illnesses, or operations, that you have had, or medications that you are currently taking.

You will not be able to use the patch if:

• you are, or think you might be, pregnant,
• you are breastfeeding, or
• you smoke and you are over 35 years of age.

There are also some medical conditions that mean that you cannot use the contraceptive patch. You will not be able to use the patch, if you have or have ever had any of the following conditions:

• thrombosis (blood clots) in a vein or artery,
• a heart problem, or disease affecting your blood circulatory system (including high blood pressure),
• serious migraines, or migraines with aura (visual problems),
• breast cancer,
• active disease of the liver or gall bladder,
• diabetes, and
• bleeding from your vagina that does not have an obvious cause (such as between periods, or after sex).

If you weigh more than 90 kilograms (14 stone) the contraceptive patch may not work as effectively, so you may want to think about using other forms of contraception.

In some women, the contraceptive patch can cause skin irritation, such as itching and soreness. It also does not protect you against sexually transmitted infections (STIs) so you may need to use condoms as well.

Some women get mild side effects when they first start using the contraceptive patch. These include:

• headaches,
• nausea (sickness),
• breast tenderness,
• mood changes, and
• slight weight gain, or loss.

However, these side effects usually settle down after a few months.

Breakthrough bleeding (bleeding between periods) and spotting (very light, irregular bleeding), is common in the first few cycles of patch use. This is nothing to worry about if you are using the patch properly, and you will still be protected against pregnancy.

Some medicines can make the patch less effective. If you are prescribed new medicine by a healthcare professional, you should tell them that you are using the patch. If you are buying over-the-counter (OTC) medicine, you should ask the pharmacist for advice because some complementary medicines, such as St John's Wort, can affect how the patch works. You might need to use an extra form of contraception while you are taking the medicine, and for two days afterwards.

If you have any questions regarding the contraceptive patch, please feel free to ask them in the comments box below. You can keep your comments anonymous too!

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An Introduction To Contraception

Monday 11th January 2010

Contraception is the use of hormones, devices or surgery to prevent pregnancy. It gives women and couples the ability to decide if and when they want a baby.

There are several types of contraception available, each working in a different way.

Over the next 11 weeks (every Monday) we will be taking a closer look at each method of contraception. How it works, side effects and answering any questions you have to help you choose the right method of contraception.

So, next week we are going to start our Contraception campaign off with the UKs most popular pregnancy prevention method, The Pill.

If you don't want to miss any of our posts on this issue then make sure you add us to your favorites!

See you tomorrow.

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Painful Sex : A Common Female Health Problem

Tuesday 10th November 2009

Painful sex? What you should know if it hurts, and how to fire your doctor if he says, "it's all in your head."

*What is one of the biggest issues facing women's sexual health

Pain with sex is a major health problem for women. The incidence is about 8 percent (anywhere between 3 percent and 15 percent depending on the study). This about the same incidence of asthma, so it is a common problem. It affects sexual fulfilment, can contribute to relationship issues, and affect a woman's self-esteem.

*I had no idea it is so common

Sadly many women suffer in silence. Our culture is filled with misperceptions and taboos concerning women's sexuality. My own mother can't tell people that I am gynecologist because it "isn't nice". Many women mistakenly believe that pain with sex is normal, that it is supposed to hurt. Some don't have the courage to broach the subject and sadly many who do speak up are dismissed by their physicians. Some are told it is "all in your head" or "have a glass of wine before" and others are misdiagnosed with chronic yeast infections.

Men have all those erectile dysfunction ads on Tv to raise awareness, but there are no ads on TV to raise awareness for women. The only TV character to ever have pain with sex was Charlotte from Sex in the City, and I think that was a brief secondary storyline. If no one talks about it, you think you are the only one.

*What are the causes

Dyspareunia, which is the medical term for painful sex has many causes. You have to think about the anatomical structures that are involved in sex. For some women it is a lubrication issue. This is more common among post menopausal women as many choose not to take hormones. Another common cause is nerve pain, a condition called vulvodynia is common. Typically the pain is more insertional. The pelvic muscles can also be involved. These muscles wrap around the vagina and can cause severe pain both with insertion and deeper penetration. Bladder inflammation, skin conditions, and even endometriosis ( a condition where the lining of the uterus grows in abnormal locations) can also cause painful sex.

* What should a woman do if she is experiencing painful sex

The first thing is to understand that pain with sex is not normal. See your doctor. Think about what makes it hurt and about any other pain you may have in the area that is not sexually related (like pain emptying your bladder). Pay attention to your menstrual cycle and see if there is any relationship. This is all helpful information. Tell your doctor if you have pain other times as well (like from your clothes touching your skin).

Insist on a diagnosis or referral to someone who can give you a diagnosis. Most of the conditions that cause pain with sex are diagnosed by history and by exam. If a skin condition is suspected a biopsy may be needed.

*Can you give us some starting points for at home

Besides thinking about when it hurts and other pains in the pelvic area, stop removing pubic hair. It is there for a reason, It protects the delicate genital skin and the process of removing hair, no matter the method, is irritating. Stop putting soaps on the vulva. I tell patients the vulva is like a self-cleaning oven, chemicals are actually damaging and strip away the natural oils. Plant based or botanical isn't any safer. Tea tree oil for example can cause skin reactions and sensitive your skin making it more vulnerable.

Use a silicone based lubricant. If that is irritating you can even use olive oil. Consider using all cotton menstrual pads.

And don't be afraid to speak up. Having a good sex life is your right. Practice what you are going to say to your doctor in the mirror before your appointment. Get comfortable saying it. You should be able to tell your doctor anything and everything and they in return should listen and help you.

Thank you to Shelly from http://y-we-sex.blogspot.com for this brilliant post.

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